In 2020, Condoleeza Rice wrote, “Our country has a birth defect: Africans and Europeans came to this country together—but one group was in chains.”

After President Joe Biden addressed the need to “confront” and “defeat” white nationalist terrorism during his inaugural speech, the former secretary of state’s admission is more relevant than ever. Rice’s analogy is among the more salient of the countless appealing but imperfect examples describing racism as a disorder or disease.

Rice’s racism as a “birth defect” analogy is profound, because it emphasizes that white nationalism is not an alien object but rather a building block of the American experiment. And the challenges it causes are ones that cannot be treated with an antibiotic or a vaccine: Racism is a part of the organism’s blueprint. Much like the effects of trisomy-21, say, racism might be managed but not fully repaired or excised.

Yet the analogy lacks some key features of how racist behavior, and especially white nationalism, works. While a birth defect typically remains local to an individual, racist ideology has grown in scope over the past few years and has percolated from the fringes of the dark web into the halls of the United States Capitol.

What about infectious diseases, then? Contagion analogies are often used broadly to describe the spread of dangerous ideas and misinformation. In the case of white nationalism, they capture the virulent nature of their ideals, how they can migrate from subpopulation to subpopulation and, in the span of a few years, corrupt whole corners of the republic.

Radicalization also involves converting individuals into white nationalists, not unlike how infectious pathogens spread from host to host. The infectious analogy also highlights the diversity of the white nationalist pathogens, sometimes cast as “strains.” For example, fringe conspiracies that are white nationalist–adjacent (e.g., QAnon) move like viruses, are highly contagious, and replicate quickly and clumsily.

Other versions of white nationalism function like parasitic infections (e.g., the disease caused by tapeworms), spreading less quickly, but involve machinery more intimately linked with human biology. The white nationalist “parasite” permeates everyday politics—hundreds of lawmakers’ indifference to (or support of) the Confederate flag or individuals running for national office who suggest that Muslims should not hold public office.

Despite these connections, the infectious disease analogy also suffers a critical limitation: It implies white nationalism is the product of a foreign agent that infects individuals’ minds or hearts. In this way, the infectious analogy is wrong specifically where the birth defects analogy is right—there is nothing foreign about white nationalism, and it didn’t need to “invade” America; it was always here.

Given that racism was always here, then what about a cancer analogy? After all, cancerous cells are our own cells, gone awry.

The analogy draws on some basics of the biology of cancer: a class of ailments defined by cells of the body that, due to the existence of mutations, undergo disregulated growth that interferes with the normal physiology of the body. This interference causes illness that can be fatal when left unchecked, and is most dangerous when it spreads from tissue to tissue throughout the body.

This analogy has been recently championed by How to Be An Antiracist author Ibram Kendi, who has spoken of “metastatic racism” to which antiracist efforts may serve as a potential cure. By extension, the notion that white nationalism is a “cancer” works well in many respects: The Capitol terrorists are homegrown Americans, not foreign nationals. They are radicalized and organized underground, and distribute their influence from internet chat rooms all the way to elected office.

Even more, white nationalism especially resembles the class of cancers caused by germline mutations, those that are passed down from parents to offspring. This is an important connection, because one might erroneously analogize white nationalism to cancers caused by somatic mutations. Germline cancers are the more meaningful analogy, because they’re related to what made Rice’s “birth defect” analogy useful—the seeds of white nationalism live in every cell of the American project.